A bladder wall thickness of more than 3-4 mm in thepresence of urine of 50% of the predicted bladder's capacity should arise suspicion of hypersensitivity of the detrusor muscle
The underlying mechanisms involve overactive detrusor muscle
or poor bladder compliance.
She also takes oxybutynin chloride extended-release tablets, (Ditropan XL), which relax the bladder (i.e., detrusor muscle
) and relieve urgency and incontinence.
Coping strategies range from manually pressing on the bladder to assist in voiding to self-catheterization and injecting botulinum toxin into the detrusor muscle
, a new therapy with some promising results.
This stimulation produces neurological signals that trigger the detrusor muscle
to contract, increasing awareness of bladder pressure.
Second, botulinum toxin is known to act on the parasympathetic nervous system by inhibiting release of acetylcholine on nerve endings, including the detrusor muscle
in the bladder.
In 4 randomised double-blinded placebo-controlled studies8101218 200U BTX-A was injected in the intra- detrusor muscle
. All studies reported a significant improvement in incontinence episodes decreased frequency and nocturia but there was also a significant increase in the post-void residual urine.
Under normal conditions, the detrusor muscle
, bladder neck, and striated external sphincter function as a synergistic unit for adequate storage and complete evacuation of urine.
Acting on the detrusor muscle
, anticholinergic drugs can relieve muscle spasms, reduce bladder pressure, and relieve symptoms in the urine storage period.
Acetylcholine released from parasympathetic nerves reaches muscarinic receptors for the stimulation of the detrusor muscle
, and anti-muscarinic drugs block this interaction to control detrusor overactivity.
Mobility, age, communication problems and spasticity of the detrusor muscle
all play a role.
Estrogen levels influence beta-3-adrenoceptor-mediated relaxation of the female rat detrusor muscle